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Journal of the Mechanical Behavior of... Feb 2023The present systematic review and meta-analysis aimed to assess the characteristics and consequences of post-processing methods after grinding procedures in YSZ ceramics... (Meta-Analysis)
Meta-Analysis Review
The present systematic review and meta-analysis aimed to assess the characteristics and consequences of post-processing methods after grinding procedures in YSZ ceramics on its surface roughness and flexural strength. The protocol of this review was made prospectively and is available online in the PROSPERO database (link). Literature searches on PubMed/MEDLINE, EMBASE, Lilacs, Web of Science and Scopus were conducted on December 2022 to select in vitro studies written in English, without publishing-date restrictions, that considered surface characteristics and mechanical properties of YSZ ceramics submitted to grinding and subsequent post-processing surface treatments as an attempt to revert the effect induced by grinding. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences (Rev-Man 5.1, random effects model, α= 0.05) were obtained by comparing flexural strength and surface roughness values of ground surfaces with at least one post-processing surface treatment (global analysis). Subgroup analyses were performed considering the most prevalent categories of post-processing methods. A total of 33 (out of 4032) studies were eligible and included in the analysis. In the global analysis, ground surfaces showed higher flexural strength than when post-processing methodologies were employed (p< 0.0001). The subgroup analysis showed that only polishing was able to enhance the flexural strength after grinding (p= 0.001); however, when other protocols were used, the ground surface was always superior in terms of flexural strength (p< 0.0001). Post-processing techniques in both the global and sub-group analyses were able to reduce the surface roughness after grinding in YSZ ceramics (p< 0.00001). High heterogeneity was found in all the meta-analyses. Concerning the risk of bias analysis, the included studies had mixed scores for the considered factors. In conclusion, in terms of improving flexural strength and restoring surface roughness after grinding, polishing protocols can be considered the best indication as post-processing treatment after YSZ ceramics adjustments/grinding.
Topics: Humans; Materials Testing; Surface Properties; Zirconium; Yttrium; Ceramics; Dental Polishing; Dental Porcelain
PubMed: 36634437
DOI: 10.1016/j.jmbbm.2023.105654 -
The Journal of Contemporary Dental... Feb 2023The systematic review presented herein was performed to descriptively analyze the causes for the failure of computer-aided design/computer-aided manufacture (CAD/CAM)... (Meta-Analysis)
Meta-Analysis
AIM
The systematic review presented herein was performed to descriptively analyze the causes for the failure of computer-aided design/computer-aided manufacture (CAD/CAM) restorations. The meta-analysis reported herein was performed to estimate long-term survival and success rates of CAD-CAM fabrications.
MATERIALS AND METHODS
Using the PICOS paradigm, a systematic search was carried out in the PubMed and Cochrane databases to identify randomized controlled trials (RCTs) and prospective observational studies reporting survival data for CAD/CAM restorations. After selecting studies with a predefined set of selection criteria, data from included prospective clinical studies and RCTs were used for a systematic review aimed at a descriptive analysis of factors associated with failure of CAD-CAM restorations. Data from the included prospective clinical studies were used for meta-analysis, wherein 5-year and 10-year survival and success rates were estimated using Poisson regression models.
RESULTS
The systematic review included data from 9 RCTs and 6 observational studies, which had a median follow-up of 36 months and 60 months, respectively. About 58 failures and 118 technical/ biological complications were noted in the included RCTs and 9 failures along with 58 technical/biological complications were noted in the prospective clinical studies. Poisson regression indicated an estimated 5-year and 10-year survival rates of 85.55-100 and 71-100, respectively. The estimated 5-year and 10-year success rates were 74.2-92.75 and 33.3-85.5, respectively.
CONCLUSION
Several technical and biological complications contribute to failure of CAD/CAM restorations. However, CAD/CAM restorations with routine chairside materials might have clinically meaningful success rates in the long term.
CLINICAL SIGNIFICANCE
The results presented herein indicate that optimal strategies for mitigation of biological and technical complications may augment the success of CAD/CAM fabrications in restorative dentistry. Studies aimed at identification of such strategies are needed to further enhance the long-term success rates of CAD/CAM restorations.
Topics: Dental Prosthesis Design; Dentistry; Computer-Aided Design; Databases, Factual; Prospective Studies; Crowns; Dental Porcelain; Ceramics; Observational Studies as Topic
PubMed: 37272145
DOI: 10.5005/jp-journals-10024-3472 -
Journal of Prosthodontic Research Jan 2023Various oral rehabilitation approaches are available for severely worn dentition. However, evidence-based guidelines for permanent treatment are limited. This review...
PURPOSE
Various oral rehabilitation approaches are available for severely worn dentition. However, evidence-based guidelines for permanent treatment are limited. This review aims to investigate clinical observational findings and compare in-vitro outcomes of thin and ultrathin occlusal veneers using different materials and approaches.
METHODS
An electronic search of online databases, such as PubMed (MEDLINE), BioMed Central (BMC), Cochrane, and Scopus, was performed for the 2009 - Jun 2021 period, following the PRISMA 2020 criteria. The reports sought for retrieval were all the articles evaluating the clinical outcomes of permanent full-mouth rehabilitation, and all in-vitro records that investigated and compared fracture strength, survival rate, and modes of failure of ultrathin (0.3 - 0.6 mm), thin (0.5 - 0.8 mm), and thick (0.8-1.5 mm) occlusal veneer restorations, with regard to the available indirect restorative materials. The Newcastle Ottawa risk of bias criteria was used to judge the clinical studies and a modified consort statement was used for the evaluation of in-vitro studies. The data of the included studies were extracted and grouped based on the similarity of the outcomes and study protocols. Data heterogeneity determined the qualitative and quantitative grouping of the results.
RESULTS
Two clinical and 17 in-vitro studies were included. Data exhibited heterogeneity within the materials, variables, testing protocols and observation periods. Therefore, only qualitative synthesis of the results was feasible. Clinically used 1 mm lithium disilicate overlays and ultrathin one-step no-prep polymer infiltrated ceramic network (PICN) occlusal veneers exhibited very high success and survival rates. The analysis of in-vitro studies exhibited variable survival rates and fracture load values, based on materials, thickness, and restorative approaches used.
CONCLUSIONS
Within the limitations of this systematic review, it can be concluded that the clinical outcomes of thin and ultrathin occlusal veneers/overlays are auspicious. In-vitro experimental results support the usage of the thin and ultrathin occlusal veneers.
Topics: Survival Rate; Materials Testing; Dental Veneers; Dental Porcelain; Ceramics; Dental Materials; Dental Stress Analysis; Computer-Aided Design
PubMed: 35545532
DOI: 10.2186/jpr.JPR_D_21_00270 -
Journal of Prosthodontics : Official... Dec 2022Several studies have compared digital intraoral scanners and conventional impressions. The accuracy of these two methods in terms of marginal accuracy of lithium... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Several studies have compared digital intraoral scanners and conventional impressions. The accuracy of these two methods in terms of marginal accuracy of lithium disilicate crowns is not well-established, yet. The purpose of this study was to systematically review available publications on marginal fit of single-unit, full-coverage, tooth-supported lithium disilicate restorations.
METHODS
Pubmed, Web of Science, Cochrane, EMBASE, and Scopus were electronically searched along with a manual search. After critical appraisal, data from selected studies were extracted and mean marginal difference with a 95% confidence interval was calculated. Meta-analysis of the collected data was conducted using STATA software.
RESULTS
The meta-analysis revealed similar marginal gap values in intraoral scanners with conventional groups (p>0.05) and in intraoral scanners with extraoral canners (p>0.05).
CONCLUSION
No significant difference was seen between digital and conventional impressions or intra- and extraoral scanners for marginal accuracy of lithium disilicate crowns.
Topics: Humans; Workflow; Dental Impression Technique; Dental Prosthesis Design; Computer-Aided Design; Dental Marginal Adaptation; Dental Porcelain; Crowns
PubMed: 35344238
DOI: 10.1111/jopr.13515 -
Dental Materials : Official Publication... Mar 2024Nonthermal atmospheric or low-pressure plasma (NTP) can improve the surface characteristics of dental materials without affecting their bulk properties. This study aimed... (Review)
Review
OBJECTIVES
Nonthermal atmospheric or low-pressure plasma (NTP) can improve the surface characteristics of dental materials without affecting their bulk properties. This study aimed to systematically review the available scientific evidence on the effectiveness of using NTP for the surface treatment of etchable, silica-based dental ceramics before cementation, and elucidate its potential to replace the hazardous and technically demanding protocol of hydrofluoric acid (HF) etching.
METHODS
A valid search query was developed with the help of PubMed's Medical Subject Headings (MeSH) vocabulary thesaurus and translated to three electronic databases: PubMed, Web of Science, and Scopus. The methodological quality of the studies was assessed according to an adapted version of the Methodological Index for Non-Randomized Studies (MINORS).
RESULTS
Thirteen in vitro study reports published between 2008 and 2023 were selected for the qualitative and quantitative data synthesis. The implemented methodologies were diverse, comprising 19 different plasma treatment protocols with various device settings. Argon, helium, oxygen, or atmospheric air plasma may significantly increase the wettability and roughness of silicate ceramics by plasma cleaning, etching, and activation, but the treatment generally results in inferior bond strength values after cementation compared to those achieved with HF etching. The technically demanding protocol of plasma-enhanced chemical vapor deposition was employed more commonly, in which the surface deposition of hexamethyl disiloxane with subsequent oxygen plasma activation proved the most promising, yielding bond strengths comparable to those of the positive control. Lack of power analysis, missing adequate control, absence of examiner blinding, and non-performance of specimen aging were common methodological frailties that contributed most to the increase in bias risk (mean MINORS score 15.3 ± 1.1).
SIGNIFICANCE
NTP can potentially improve the adhesive surface characteristics of dental silicate ceramics in laboratory conditions, but the conventional protocol of HF etching still performs better in terms of the resin-ceramic bond strength and longevity. More preclinical research is needed to determine the optimal NTP treatment settings and assess the aging of plasma-treated ceramic surfaces in atmospheric conditions.
Topics: Dental Porcelain; Dental Bonding; Surface Properties; Resin Cements; Ceramics; Silicates; Oxygen; Materials Testing; Hydrofluoric Acid; Silanes
PubMed: 38281846
DOI: 10.1016/j.dental.2024.01.001 -
Primary Dental Journal Mar 2023A range of materials for single-tooth computer-aided design and computer-aided manufacturing (CAD-CAM) restorations have been introduced that may affect CAM accuracy....
PURPOSE
A range of materials for single-tooth computer-aided design and computer-aided manufacturing (CAD-CAM) restorations have been introduced that may affect CAM accuracy. This study aimed to review articles evaluating marginal and internal fit of lithium disilicate (LD) and zirconia (Z) crowns fabricated by CAD-CAM systems using intraoral optical scanners (IOS).
MATERIALS AND METHODS
Under the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA), a systematic review was performed along with an electronic article search in the Medline/Pubmed database. The articles were limited to those in the English language that were published within the past ten years.
RESULTS
The initial search resulted in 50 articles and of those, a total of 18 articles were selected for full-text review following abstract evaluation. Eight articles that did not meet the inclusion criteria were excluded and the remaining ten articles, which provided internal and marginal gap values, were used in this review. For LD crowns, marginal gap values ranged between 45µm and 190.2µm. For Z crowns, the values varied between 39µm and 126.4µm. For LD crowns, the internal gap values were between 57.8µm and 475.4µm, and for Z crowns, the values were between 79µm and 205.8µm.
CONCLUSION
The outcome of this review suggests that clinically acceptable marginal and internal fit can be attained with LD and Z all-ceramic CAD-CAM crowns using digital impressions. Additionally, it has been found that LD and Z ceramics provide similar marginal gap values, but LD material provides better internal fit than Z.
Topics: Humans; Dental Marginal Adaptation; Dental Prosthesis Design; Dental Porcelain; Ceramics; Crowns; Computer-Aided Design
PubMed: 36916623
DOI: 10.1177/20501684231154323 -
Journal of Clinical and Experimental... Mar 2024The aim of this systematic review is to determine the effectiveness of self-etching primers in comparison to the conventional protocol with hydrofluoric acid and silane... (Review)
Review
BACKGROUND
The aim of this systematic review is to determine the effectiveness of self-etching primers in comparison to the conventional protocol with hydrofluoric acid and silane treatment for bonding lithium disilicate ceramics.
MATERIAL AND METHODS
The formulated PICO question for this research was: "Does self-etching silane primer surface treatment in lithium disilicate ceramics present a similar bond strength value compared to conventional hydrofluoric acid and silane treatment?". Combinations of words and appropriate truncations were adapted for each database. For the selection, duplicate articles were systematically eliminated using Mendeley software. The Cohen's Kappa statistic was then computed, RoBDEMAT questions were addressed, and the meta-analyses were conducted using RevMan 5.4, at a significance level of 5%.
RESULTS
Two independent reviewers conducted a blind and independent analysis of 190219 articles from PubMed, Scopus, Web of Science, and OpenGrey. Subsequently, they extracted data from 21 studies for the systematic review and in 16 the meta-analysis. In all in vitro studies, the most frequently cited concentration of hydrofluoric acid was 5%. In the meta-analysis, no statistical differences were observed between the two treatments concerning bond strength.
CONCLUSIONS
Self-etching silane primers demonstrate promising results in lithium disilicate bonding, suggesting their potential as an alternative surface treatment to hydrofluoric acids + silane. Lithium disilicate, Hydrofluoric acid, Dental Porcelain, Ceramics, Silanes.
PubMed: 38600931
DOI: 10.4317/jced.61369 -
Journal of Dentistry Mar 2024The aim of this study was to evaluate the amount of enamel tooth wear induced by different antagonistic ceramic crown materials in the posterior area within a follow-up... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of this study was to evaluate the amount of enamel tooth wear induced by different antagonistic ceramic crown materials in the posterior area within a follow-up period up to 24 months in function. A network meta-analysis was performed to assess the effect of the materials on the mean vertical loss (MVL) of the antagonist enamel tooth surface.
DATA
Main search terms used in combination: ceramic, dental materials, metal ceramic, tooth wear and dental enamel.
SOURCES
An electronic search was conducted in PubMed/Medline, Embase, and Cochrane CENTRAL plus hand-searching.
STUDY SELECTION
Eligibility criteria included clinical studies reporting on MVL on antagonist's tooth up to 24 months following the permanent crown placement. From a total of 5697 articles, 7 studies reporting on 261 crowns for 177 subjects with 3 ceramic materials (Lithium disilicate, metal-ceramic, monolithic zirconia) were included. Among all, metal-ceramic and zirconia caused significantly higher enamel tooth wear on antagonist teeth, representing 82.5 µm [54.4; 110.6]) and 40.1 µm [22.2; 58.0]) more MVL than natural teeth group. In contrast, lithium disilicate showed only 5.0 µm [-48.2; 58.1]) more MVL than occurs on opposing natural teeth.
CONCLUSIONS
This systematic review demonstrated that prosthodontic ceramic materials produced significantly more antagonist enamel tooth wear than opposing natural enamel tooth wear, and ceramic material type was correlated to the degree of enamel tooth wear. Additional well-conducted, randomized controlled trials with homogeneous specimens are required due to inadequate sample size and number of the clinical studies included in the analyses.
CLINICAL SIGNIFICANCE
The amount of wear caused by different restorative materials has a high influence on the antagonistic natural teeth and should therefore be evaluated intensively by the dentist.
Topics: Humans; Ceramics; Crowns; Dental Enamel; Dental Porcelain; Dental Restoration Wear; Materials Testing; Network Meta-Analysis; Surface Properties; Tooth Wear; Zirconium; Controlled Clinical Trials as Topic
PubMed: 38211687
DOI: 10.1016/j.jdent.2024.104832 -
The International Journal of... 2022To describe the possible adverse effects of sodium hypochlorite (NaOCl) solutions, high-concentration alcohol solutions, and povidone-iodine products, which are...
PURPOSE
To describe the possible adverse effects of sodium hypochlorite (NaOCl) solutions, high-concentration alcohol solutions, and povidone-iodine products, which are indicated for disinfection of inanimate surfaces against human coronavirus of the severe acute respiratory syndrome (SARS-CoV), on prosthesis materials, including zirconia, lithium disilicate, and acrylic resin.
MATERIALS AND METHODS
A systematic literature research for articles published between January 2010 and February 2020 was conducted in Scopus, PubMed/Medline, Web of Science, Embase, and Science Direct using a combination of the following MeSH/Emtree terms and keywords: sodium hypochlorite, alcohol, ethanol, povidone-iodine, dental ceramic, zirconia, lithium disilicate, and acrylic resin.
RESULTS
A total of 538 studies were identified in the search during initial screening, of which 44 were subject to full-text evaluation, and 24 fulfilled the inclusion criteria. Seven articles on zirconia and lithium disilicate investigated the effect of NaOCl (0.5% and 1%), 96% isopropanol, and 80% ethanol on bond strength after saliva contamination. The remaining articles evaluated color alteration, surface roughness modifications, decrease in flexural strength, and bonding strength of all cleaning agents on acrylic resin.
CONCLUSION
NaOCl (1%) solution for 1 minute is recommended to reduce SARS-CoV infectivity and to minimize the risk of cross-contamination through prosthetic materials. The increase in surface roughness and color alteration were recorded using 1% NaOCl on acrylic resin, but this increase was not clinically significant. A decrease in bonding strength was determined after using 1% NaOCl, 96% isopropanol, and 80% ethanol solutions on lithium disilicate. Silanization before the try-in procedure and the application of the second layer of silane after cleaning methods are recommended to improve the bonding strength.
Topics: 2-Propanol; Acrylic Resins; COVID-19; Ceramics; Dental Bonding; Dental Porcelain; Dental Stress Analysis; Disinfection; Ethanol; Humans; Materials Testing; Pandemics; Povidone-Iodine; Resin Cements; Sodium Hypochlorite; Surface Properties; Zirconium
PubMed: 33662052
DOI: 10.11607/ijp.7151 -
Clinical Oral Investigations Aug 2022This systematic review was performed to determine the main cause of technical failure of tooth-supported zirconia crowns and fixed partial dentures (FPDs), categorizing... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review was performed to determine the main cause of technical failure of tooth-supported zirconia crowns and fixed partial dentures (FPDs), categorizing them as fracture/chipping or loss of retention/decementation.
MATERIALS AND METHODS
Electronic and manual searches were performed for randomized clinical trials, prospective clinical trials, and prospective cohort studies that reported the technical failure rates of zirconia restorations. The Cochrane Collaboration risk-of-bias tool and Newcastle-Ottawa scale were used to assess the quality of the studies.
RESULTS
Fifty-two studies were included and most of them had unclear risk of bias. Considering all reported fractures/chipping, for veneered crowns with 1 to 3 years of follow-up, the relative risk (RR) of fracture in relation to loss or retention was 3.95 (95% CI 1.18-13.23; p = 0.03). For 4 to 6 years of follow-up, the RR was 5.44 (95% CI 1.41-20.92; p = 0.01). For veneered FPDs with 1 to 3 years of follow-up, the RR was 5.98 (95% CI 2.31-15.01; p = 0.0002). For 4 to 6 years of follow-up, the RR was 3.70 (95% CI 1.63-8.41; p = 0.002). For 7 years or more of follow-up, the RR was 3.45 (95% CI 1.84-6.46; p = 0.0001). When only framework fractures were considered, there were no significant differences for the RR in all follow-up periods (p > 0.05).
CONCLUSIONS
Higher RR for fracture/chipping in relation to decementation for veneered zirconia crowns and FPDs at all follow-up times. For framework fractures, no difference was observed between the risk of failure of the restoration due to fracture or decementation.
CLINICAL RELEVANCE
Zirconia crowns and FPDs showed relatively high success and survival rates. However, considering the technical failures, there is approximately four times higher chance of fracture/chipping than loss of retention for both single and multi-unit tooth-supported veneered zirconia restorations.
Topics: Crowns; Dental Porcelain; Dental Restoration Failure; Denture, Partial, Fixed; Humans; Prospective Studies; Zirconium
PubMed: 35660957
DOI: 10.1007/s00784-022-04573-z